Infection Control, Sterilization, and Workplace Safety
Standard precautions
Treat every patient as potentially infectious. Hand hygiene before and after glove use; PPE matched to anticipated exposure (gloves, mask, eye protection, gown); engineered sharps devices; no two-handed recapping; immediate disposal in a rigid sharps container.
Sterilization
Instruments are cleaned (ultrasonic or washer-disinfector), dried, packaged with a chemical indicator, and sterilized by steam autoclave, chemical vapor, or dry heat; heat-sensitive items follow manufacturer instructions or are single-use. Handpieces and prophy angles are sterilized between patients. Packages are dated and stored so sterility is maintained.
Monitoring
Every load: mechanical gauge/temperature/pressure and a chemical indicator. Weekly: a biological spore test for each sterilizer, with records kept. A positive spore test means removing the unit from service, reviewing loading and technique, re-testing, and recalling items processed since the last negative test where feasible.
Surfaces, water, and waste
Clean then disinfect with an EPA-registered hospital disinfectant; use barriers on high-touch items. Dental unit waterlines must be maintained and treated, with output meeting the accepted standard (≤500 CFU/mL). Regulated waste and sharps go into labeled containers. Cal/OSHA requires a written exposure control plan, annual training, an offered hepatitis B vaccination, post-exposure evaluation, and a sharps injury log.
Traps
Believing a chemical indicator proves sterilization (it only shows process exposure); thinking spore testing is per load; skipping disinfection because a surface "looks clean"; forgetting exposure-control plan and training documentation.
Worked example: A spore test returns positive Monday. Stop using the autoclave, quarantine it, review the load records, notify the infection-control lead, repeat testing, and recall patients whose instruments were processed since the last negative test.